Improvement of the thermal amplitude after rituximab treatment for cold agglutinin disease with Waldenstrom's macroglobulinemia

摘要

Cold agglutinin disease (CAD) is an uncommon autoimmune hemolytic anemia characterized by the production of cold agglutinins (CA) [1], CA exhibits the strongest affinity for the antigen at 0-4degC but binding may occur at temperatures approaching the normal body temperature of mammals, depending on the thermal amplitude of the antibody. Rituximab has been demonstrated to be useful in treating CAD that is refractory to conventional therapies [2]. However, CA titers did not concur with the observed clinical and hematologic responses, and it has become apparent that the CA titer is not an important index for the clinical features of CAD. The detailed effect(s) of rituximab on CAD have not been reported.